ArticleGastroenterology2023
Prospective, Multi-Institutional, Real-Time Next-Generation Sequencing of Pancreatic Cyst Fluid Reveals Diverse Genomic Alterations That Improve the Clinical Management of Pancreatic Cysts.
Article in Gastroenterology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 94 papers.
What it found
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Who cites it
94 citing papers in PubMed, 167 citations in OpenAlex.
- The Impact of Endoscopic Ultrasound and Multidisciplinary Team Evaluation on the Management of Pancreatic Cystic Lesions.United European gastroenterology journal · 2026Trial
- Structured training program on confocal laser endomicroscopy for pancreatic cystic lesions: a multicenter prospective study among early-career endosonographers (with video).Gastrointestinal endoscopy · 2023Trial
- Pancreatic Cancer Early Detection Biomarkers for High-Risk Individuals: Insights From the PRECEDE Consortium.International journal of cancer · 2026Review
- Quantitative CT-Derived Imaging Features Improve Preoperative Risk Stratification of Intraductal Papillary Mucinous Neoplasms.Annals of surgical oncology · 2026Article
- Discordant pathology following pancreatoduodenectomy for suspected intraductal papillary mucinous neoplasm: reassessment of cyst fluid genetic analysis.Journal of surgical case reports · 2026Article
- Cancer Risk After Initial Surveillance of Intraductal Papillary Mucinous Neoplasms (IPMNs): Are We Missing the Window for Prevention?Annals of surgical oncology · 2026Article
- Impact of Next-Generation Sequencing on Surgical Decision-Making in Branch-Duct IPMN.Annals of surgical oncology · 2026Article
- DNA/RNA-Based Next-Generation Sequencing Improves the Early Diagnosis and Management of Neoplastic Bile Duct Strictures: A 6-Year, Prospective, Multi-Institutional, Real-Time Study.Gastroenterology · 2026Article
- The Surveillance Strategy for Intraductal Pancreatic Mucinous Neoplasms: Criteria for Discontinuation.Annals of surgery · 2026Article
- Molecular pathology of intraductal papillary mucinous neoplasms of the pancreas: current understanding and perspectives on malignant progression.Journal of gastroenterology · 2026Review
- Imaging-Based Risk Stratification of IPMN Using a Structured Imaging Score: A Retrospective Proof-of-Concept Study.Current oncology (Toronto, Ont.) · 2026Article
- Cytology andJournal of clinical medicine · 2026Article
- Role of Endoscopic Ultrasonography in Management of Pancreaticobiliary Cancers: Recent Trends and Advances.Cancers · 2026Review
- Multidisciplinary Team Approach for Managing Pancreatic Cysts: Impact, Bias, and Opportunities for Improvement.United European gastroenterology journal · 2026Article
- Artificial intelligence for pancreatic cyst dysplasia grading: a multicenter endoscopic ultrasound study.iGIE : innovation, investigation and insights · 2026Article
- Cystic neoplasms of pancreas.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Review
- PancreaSeq Genomic Classifier (PancreaSeq GC) Improves Pancreatic Cyst Classification and Detection of Advanced Neoplasia: A Multi-institutional Validation Study.Annals of surgical oncology · 2026Article
- Pancreatic Cystic Lesions and Endoscopic Ultrasound Diagnostic Equipment: A Literature Review.Journal of clinical medicine · 2026Review
- Diagnosis of Von Hippel-Lindau Syndrome Via Pancreatic Cyst Fluid Next-Generation Sequencing.ACG case reports journal · 2026Article
- Immunogenomic Characterization of Malignant Transformation in Intraductal Papillary Mucinous Neoplasms.Cellular and molecular gastroenterology and hepatology · 2026Article
34 more citing papers are in PubMed but not listed here.
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Authors and funding
68 authors at 15 institutions in 2 countries.
Funding
Abstract
BACKGROUND &
aimsNext-generation sequencing (NGS) of pancreatic cyst fluid is a useful adjunct in the assessment of patients with pancreatic cyst. However, previous studies have been retrospective or single institutional experiences. The aim of this study was to prospectively evaluate NGS on a multi-institutional cohort of patients with pancreatic cyst in real time.
methodsThe performance of a 22-gene NGS panel (PancreaSeq) was first retrospectively confirmed and then within a 2-year timeframe, PancreaSeq testing was prospectively used to evaluate endoscopic ultrasound-guided fine-needle aspiration pancreatic cyst fluid from 31 institutions. PancreaSeq results were correlated with endoscopic ultrasound findings, ancillary studies, current pancreatic cyst guidelines, follow-up, and expanded testing (Oncomine) of postoperative specimens.
resultsAmong 1933 PCs prospectively tested, 1887 (98%) specimens from 1832 patients were satisfactory for PancreaSeq testing. Follow-up was available for 1216 (66%) patients (median, 23 months). Based on 251 (21%) patients with surgical pathology, mitogen-activated protein kinase/GNAS mutations had 90% sensitivity and 100% specificity for a mucinous cyst (positive predictive value [PPV], 100%; negative predictive value [NPV], 77%). On exclusion of low-level variants, the combination of mitogen-activated protein kinase/GNAS and TP53/SMAD4/CTNNB1/mammalian target of rapamycin alterations had 88% sensitivity and 98% specificity for advanced neoplasia (PPV, 97%; NPV, 93%). Inclusion of cytopathologic evaluation to PancreaSeq testing improved the sensitivity to 93% and maintained a high specificity of 95% (PPV, 92%; NPV, 95%). In comparison, other modalities and current pancreatic cyst guidelines, such as the American Gastroenterology Association and International Association of Pancreatology/Fukuoka guidelines, show inferior diagnostic performance. The sensitivities and specificities of VHL and MEN1/loss of heterozygosity alterations were 71% and 100% for serous cystadenomas (PPV, 100%; NPV, 98%), and 68% and 98% for pancreatic neuroendocrine tumors (PPV, 85%; NPV, 95%), respectively. On follow-up, serous cystadenomas with TP53/TERT mutations exhibited interval growth, whereas pancreatic neuroendocrine tumors with loss of heterozygosity of ≥3 genes tended to have distant metastasis. None of the 965 patients who did not undergo surgery developed malignancy. Postoperative Oncomine testing identified mucinous cysts with BRAF fusions and ERBB2 amplification, and advanced neoplasia with CDKN2A alterations.
conclusionsPancreaSeq was not only sensitive and specific for various pancreatic cyst types and advanced neoplasia arising from mucinous cysts, but also reveals the diversity of genomic alterations seen in pancreatic cysts and their clinical significance.
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